When What Counts at Work Cannot Be Counted

Recently, I was talking with a physician about his work.

He told me that an increasing part of his working day is now devoted to administrative tasks: documenting what he has done, providing information, and justifying medical decisions to insurance companies.

At one point, he said something that stayed with me: “Fortunately, I love my work. Otherwise, it would be becoming very difficult to do it.”

He also described something else.

The administrative work has become so demanding, and he experiences it as interfering so much with his medical activity, that he has begun to resist it. Instead of completing it continuously, as he is expected to do, he postpones it. He does it when he can. For now, this allows him to preserve time for what he considers the essential part of his work.

But it creates a tension.

And as I listened to him, I found myself wondering: what exactly are we making visible when we make work visible?

What becomes visible at work?

The physician is spending increasing amounts of time documenting and justifying his work.

Yet perhaps some of the most important parts of his work leave very little trace.

The time spent listening to a patient. The way he notices that something does not quite fit the initial diagnosis. The few additional minutes he gives someone who is worried. The words he chooses to explain something difficult. The experience that allows him to sense when further investigation is necessary—or when reassurance may be enough.

These dimensions of work are difficult to document. Yet they are not secondary to medical work.

They are part of the medical work itself. And they are essential to its quality.

This raises a broader question.

In many organizations today, considerable effort is devoted to making work visible. We measure activities. We document decisions. We define indicators. We report results. We demonstrate compliance.

There are, of course, reasons for doing this. Organizations need accountability, coordination and ways of evaluating what they do.

But there is a risk: What can be documented can gradually become confused with what matters. And much of what matters in work cannot easily be counted.

A teacher notices that a student has stopped participating and changes the way she approaches them. A nurse detects a subtle change in a patient’s condition. A manager senses that a conflict is emerging and creates space for a conversation before it escalates.

These actions may never appear in a report.

Sometimes they consist not in doing more, but in observing, waiting, adjusting or choosing differently.

The invisible work behind the visible result

Work is never simply the execution of what has been prescribed.

Between what we are asked to do and what the situation actually requires, there is always a gap.

People interpret situations, make choices, deal with unexpected events, reconcile conflicting demands and decide what deserves their attention.

This activity is often invisible precisely because, when it is done well, nothing remarkable happens.

The patient feels heard.
The student remains engaged.
The conflict does not escalate.
The problem is solved before it becomes a problem.

We see the result. We rarely see the work that made the result possible.

And when organizations become increasingly focused on what can be demonstrated, recorded and measured, something important can happen: entire dimensions of the work itself may gradually lose their place, simply because they are harder to make visible.

The paradox of what we choose to value

There is another reason why this question may be becoming particularly important.

Many of the dimensions of work that organizations have learned to make most visible are also those that can most easily be formalized. And these are precisely the dimensions of professional activity that artificial intelligence may increasingly be able to support—or partly perform.

This creates a strange paradox.

At the very moment when technology is becoming increasingly capable of taking over standardized and formalizable tasks, we may be asking professionals to devote more and more of their time to them.

Meanwhile, the dimensions of work that are harder to formalize—judgment, attention, experience, relationship, sensitivity to a particular situation—remain much less visible.

Perhaps the question is therefore not only what technology will replace.

It is also whether we are sufficiently protecting the parts of human work that we actually want to preserve.

When resistance protects the work

What also struck me in this physician’s story was his resistance.

His decision to postpone administrative work could easily be interpreted as poor compliance or poor organization.

But looked at from the perspective of real work, something else appears.

His resistance can also be understood as an attempt to protect what he considers the essential part of his work. He is navigating competing demands. For now, he is preserving the time and attention he believes his patients require.

But individual resistance has limits. It creates tension. It transfers the problem onto the individual, who must constantly decide what to postpone, what to prioritize and what consequences he is prepared to accept.

And it made me ask him another question: Do you have colleagues with whom you can talk about this?

He told me that he did.

Perhaps this is crucial.

Because when the conditions for doing good work become increasingly difficult, the answer cannot depend indefinitely on each person’s capacity to resist alone. Collective discussion can make these tensions visible in another way: not as individual difficulties to be managed, but as questions about the work itself. It can create a space to examine what needs to be protected, negotiated or changed.

Protecting what cannot be counted

Perhaps one of the challenges for organizations today is therefore not simply to make work more visible. It is to become better at seeing what their systems of visibility fail to capture.

What do people actually have to do for quality work to happen?
What adjustments, judgments, conversations and forms of attention make the visible results possible?
And what parts of this work are currently being squeezed out because they cannot easily be translated into indicators?